Objective: To study the effects of starting antiretroviral treatment (ART) prior the age of two years on the growth (height and weight) of HIV-infected children. Methodology: This was a retrospective cohort study. HIV...Objective: To study the effects of starting antiretroviral treatment (ART) prior the age of two years on the growth (height and weight) of HIV-infected children. Methodology: This was a retrospective cohort study. HIV-infected children on ART aged less than 15 years were divided into two groups Group 1 (G1) comprising children who started ART prior 2 years and Group (G2) those put on treatment thereafter. Main Measures: Percentage of children with growth retardation measured by Height for Age (H/A) and Weight for Age (W/A) Results: In total, we included 90 subjects. The median age was 10 years with a slight female predominance (51.2%). Most children were asymptomatic at the time of the study (96.6%), compliant with treatment (81%), 54.8% of children were on cotrimoxazole, 33% knew their status. At initiation, underweight was predominant in group 1 compared to group 2 (52% versus 29.5%;p = 0.015). Conversely, stunted growth predominated in G2 compared to G1 but without significant difference (38% versus 50%;p = 0.147). At the time of our study (median age of 10 years), catch-up height and weight predominated in G1 compared to G2;only a small proportion remained below −2SD (4% versus 18.2%;p = 0.015 and 9% versus 29.5%;p = 0.006 respectively for underweight and stunted growth). Conclusion and Global Health Implications: Growth retardation was common at ART initiation. Catch-up in height was more evident in the early treatment group. Initiation of ART before the age of 2 years rather influences children’s height than weight. The result of this study further emphasizes the need of early ART and closed clinical monitoring to better assess the impact of ART in areas with high rates of undernutrition.展开更多
Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with H...Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.展开更多
Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HI...Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HIV-infected patients aged 5-18 years receiving antiretroviral treatment with CD4 T-lymphocytes>25%or>500 cells/mm3 for at least 6 months.QuantiF ERON-TB Gold,T-SPOT.TB,and tuberculin skin test were performed in each patient.Results:A total of 50 patients were enrolled with median age of 13.7 years,CD4 counts of 753(IQR:587-989)cells/mm3.Among 27 patients with tuberculosis(16)or tuberculosis exposure(11),8(29.6%)were positive to at least one test,2(7.4%)were positive QuantiFERON-TB Gold,3(11.1%)positive T-SPOT.TB,and 7(25.9%)had tuberculin skin test≥5 mm.Among 23 patients without history of tuberculosis or exposure,all had negative interferon gamma release assays,while 2(8.7%)had positive tuberculin skin test.Conclusions:All tests had low sensitivity despite immune reconstitution.展开更多
Objectives: Antiretroviral therapy (ART) has been associated with lipodystrophy in children. We evaluated changes in various anthropometric measurements for the assessment of lipodystrophy and assessed whether there w...Objectives: Antiretroviral therapy (ART) has been associated with lipodystrophy in children. We evaluated changes in various anthropometric measurements for the assessment of lipodystrophy and assessed whether there was an association with use of protease inhibitors (PI), non-PI containing ART and/or stavudine (d4T). Methods: Eighty-five HIV-infected children attending the HIV clinic at Great Ormond Street Hospital (GOSH) were included. The average follow-up was 8.4 months (range 3 - 12 months). Body fat redistribution was assessed by anthropometric measurements including skinfold thickness and circumferences of upper and lower limbs. Measurements were converted to age- and sex-adjusted z-scores through development stages including puberty. Results: Sixty children had taken ART;37 received PI-containing;38 received d4T;25 had never been treated. In the studied population, clinically important changes with decreases in biceps (BSF), subscapular skinfolds and total body fat (4SFT) over period of 12 months were observed. Some increase was noticed in triceps skinfolds (TSF). Limbs circumferences remained at the same level. Further we looked at 4 months basis changes in anthropometric measurements stratified by baseline ART. Generally z-scores of anthropometric measurements were lower in therapy naive children when compared to ART groups. PI-based ART regimens resulted in significant increases in BSF with a trend towards increases in TSF, suprailiac and 4SFT. Mid-arm and thigh circumferences were higher in PI compared to naive group. Similarly, significant changes in BSF z-scores were associated with d4T use. Increases were seen in TSF and mid-arm circumference and decreases were observed in subscapular skinfolds and calf circumference z-scores. Conclusions: Body fat redistribution in HIV-infected children with sub-clinical lipodystrophy could be detected by anthropometric measurements, particularly when PI or d4T is included in ART. Over time, changes with increase in arm and trunk fat, and no change or decrease in leg fat were more pronounced among ART-receiving children.展开更多
Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngea...Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngeal colonization is a risk factor for pneumococcal disease, a leading cause of complications and death in infants. HIV-infected persons are at high risk of invasive pneumococcal disease. Method: Nasopharyngeal swabs were collected from 296 HIV infected children below five years recruited from Gertrude’s Children hospital and Nazareth Hospital Nairobi, Kenya. The nasopharyngeal swabs were processed to isolate S. pneumoniae, which were serotyped and tested for drug susceptibility. Results: The carriage prevalence of S. pneumoniae in the study was 30.4% while the isolated serotypes were (in order of decreasing frequency): 35B, 19F, 3, 13, 15A, 11A, 16F, 7C and 23A. Most of the serotypes were resistant to the commonly used antibiotics but all were susceptible to vancomycin and chloramphenicol. Conclusion: Carriage prevalence of nasopharyngeal S. pneumonia in HIV infected children was lower than that of similar prevalence studies in children. Most of the S. pneumoniae isolates were however non pneumococcal vaccine isolates.展开更多
Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on healt...Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on health outcomes and underscores the necessity for comprehensive strategies to address them. Background: Overweight and obesity have been observed in patients with human immunodeficiency virus (HIV) both before and after the initiation of antiretroviral therapy. This study investigates the risk factors associated with overweight and obesity in HIV-infected patients. Methods: A total of 492 HIV-infected patients, both treatment-naïve and those undergoing treatment, were recruited from Yaoundé Central Hospital in Cameroon. Demographic, anthropometric, and biochemical data were collected from each patient. Blood pressure and abdominal fat measurements were also taken. Metabolic syndrome was defined according to IDF criteria. Patients were categorized into two weight status groups: underweight/normal weight and overweight/obese. Results: The prevalence of overweight and obesity was found to be 27.5% and 8.5%, respectively, with only 6.1% of patients being underweight. Abdominal obesity, systolic/diastolic blood pressure, metabolic syndrome, and CD4 cell counts were associated with risk factors in overweight and obese patients. These parameters should be considered when investigating metabolic disorders in HIV-infected patients, as in the general population. Conclusion: Our study indicates a high risk of developing metabolic syndrome among overweight/obese individuals, who were 5.7 times more likely to have metabolic syndrome compared to those of normal weight/underweight. These findings support the hypothesis that overweight and obesity are also prevalent in HIV-infected patients and they are risk factors that have to be taken into consideration to better manage this issue. These results may provide essential information on the fact that being underweight is not the only issue to take into consideration in these patients but that overweight/obesity is now present. Prevention and management strategies should consider both aspects.展开更多
Mycoplasma pneumoniae(M.pneumoniae)is a common pathogen that causes community-acquired pneumonia in children.The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractor...Mycoplasma pneumoniae(M.pneumoniae)is a common pathogen that causes community-acquired pneumonia in children.The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractory cases.Complications may occur,such as necrotizing pneumonia and respiratory failure.Extrapulmonary complications,including encephalitis,myocarditis,nephritis,hepatitis,or even multiple organ failure,can also arise.In this editorial,we dis-cuss the clinical implications of the significant findings from the article"Serum inflammatory markers in children with M.pneumoniae pneumonia and their predictive value for mycoplasma severity"published by Wang et al.They reported that measuring lactic dehydrogenase,interleukin-6 levels,and D-dimer effectively predicts refractory M.pneumoniae pneumonia cases.展开更多
Objective: Studies available on cognitive function among school-aged HIV-infected African and in particular Nigerian children are few. The purpose of the study was to assess the neurocognitive function of a group of H...Objective: Studies available on cognitive function among school-aged HIV-infected African and in particular Nigerian children are few. The purpose of the study was to assess the neurocognitive function of a group of HIV-infected schoolaged (6 - 15 years) children using the Raven’s Standard Progressive Matrices (RPM). Method: Cognitive assessments of 69 HIV positive children and 69 age- and sex-matched apparently healthy HIV negative control children were performed using the Raven’s Standard Progressive Matrices (RPM). The children were subdivided (Piaget’s developmental staging) into two sub-groups: the concrete operation stage (6 - 11 years) and the formal operation stage (12 - 15 years) for analysis. Result: The mean RPM score for the HIV positive children was 18.2 (8.0 - 47.0, SD 9.8) which was significantly lower than the score of 27.2 (8.0 - 52.0, SD 13.8) for the HIV negative children (p < 0.001). On the RPM grading and using the HIV negative children as the standard, 56.5% of the HIV positive children had cognitive performance at below average to intellectually defective range. Conclusion: School-aged HIV positive children had significantly lower cognitive scores compared with age and gender-matched HIV negative children. Routine neuropsychological evaluation of all school-aged HIV-infected children is recommended. Early detection of cognitive impairment will help in planning appropriate interventions.展开更多
Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention a...Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.展开更多
·AIM:To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).·METHODS:This observational case-control study included a case gro...·AIM:To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).·METHODS:This observational case-control study included a case group of 122 children less than two years of age with CNLDO who underwent probing and irrigation treatment at the ophthalmology department of Imam Khomeini Hospital in Ahvaz,Iran,from June 2022 to June2024.A control group of 122 age-matched children without CNLDO was also included for comparison.Data was collected from the children's medical records.·RESULTS:The study found a significant correlation between the occurrence of CNLDO and several maternal factors,such as preeclampsia,the use of levothyroxine,hypothyroidism,having more than three pregnancies(gravidity>3),natural pregnancy,and gestational diabetes mellitus.Additionally,in children,factors,such as oxygen therapy,anemia,reflux,jaundice,and a family history of CNLDO in first-degree relatives were associated with CNLDO,and maternal preeclampsia and hypothyroidism were found to significantly increase the risk of developing CNLDO in children.·CONCLUSION:Given that CNLDO affects both premature and full-term children,the present findings may potentially facilitate the early identification of children and infants at risk of nasolacrimal duct obstruction,thereby preventing the onset of chronic dacryocystitis.展开更多
Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase bra...Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).展开更多
BACKGROUND Emotional reactions,such as anxiety,irritability,and aggressive behavior,have attracted clinical attention as behavioral and emotional problems in preschool-age children.AIM To investigate the current statu...BACKGROUND Emotional reactions,such as anxiety,irritability,and aggressive behavior,have attracted clinical attention as behavioral and emotional problems in preschool-age children.AIM To investigate the current status of family rearing,parental stress,and behavioral and emotional problems of preschool children and to analyze the mediating effect of the current status of family rearing on parental stress and behavioral/emo-tional problems.METHODS We use convenience sampling to select 258 preschool children in the physical examination center of our hospital from October 2021 to September 2023.The children and their parents were evaluated using a questionnaire survey.Pearson's correlation was used to analyze the correlation between child behavioral and emotional problems and parental stress and family rearing,and the structural equation model was constructed to test the mediating effect.RESULTS The score for behavioral/emotional problems of 258 preschool children was(27.54±3.63),the score for parental stress was(87.64±11.34),and the score for parental family rearing was(31.54±5.24).There was a positive correlation between the behavioral and emotional problems of the children and the“hostile/mandatory”parenting style;meanwhile,showed a negative correlation with the“support/participation”parenting style(all P<0.05).The intermediary effect value between the family upbringing of parents in parental stress and children's behavior problems was 29.89%.CONCLUSION Parental family upbringing has a mediating effect between parental stress and behavioral and emotional problems of children.Despite paying attention to the behavioral and emotional problems of preschool-age children,clinical medical staff should provide correct and reasonable parenting advice to their parents to promote the mental health of preschool-age children.展开更多
Determining the predictors of screen media use will assist nurses and clinicians to identify the children that are in most need for intervention. There is limited literature regarding the predictors of screen media us...Determining the predictors of screen media use will assist nurses and clinicians to identify the children that are in most need for intervention. There is limited literature regarding the predictors of screen media use among children. This study aimed to examine the association between selected predictors and screen media use among children aged 3 - 13. The findings of this study are based on 192 children aged 3 - 13 and their caregivers recruited from Facebook and WhatsApp groups. A descriptive cross-sectional design was employed. The participants filled a demographic questionnaire and the Problematic Media Use Measure Short Form to obtain data about parents’ and children characteristics, screen time and problematic use of media. The screen time for 83% of the children was more than two hours. Mobile ownership (beta (β) = 0.22) and conflict about mobile use (beta (β) = 0.16) have significantly predicted the child total screen time. Child age (beta (β) = 0.17) and conflict about mobile use (beta (β) = −0.33) have significantly predicted the problematic use of media. Most children in the current study exceeded the recommended screen time. There is an urgent need to implement interventions that mitigate children’s excessive use of media.展开更多
Background: In children, acute bacterial rhinosinusitis (ABRS) is often complicated by ophthalmological and/or neurological involvement. These complications should be known and recognized, as they require urgent treat...Background: In children, acute bacterial rhinosinusitis (ABRS) is often complicated by ophthalmological and/or neurological involvement. These complications should be known and recognized, as they require urgent treatment with intravenous antibiotics and close in-hospital monitoring. In this study, we aimed to identify the main risk factors associated with the development of complications in children aged 2 - 17 years with ABRS. Methods: We conducted a retrospective cohort study of patients with ABRS complications in a primary hospital. Participants were divided into two groups: the control group comprising patients without complications (Group 1, n = 82) and the study group comprising patients with complications requiring hospitalization (Group 2, n = 41). We assessed the sociodemographic, clinical, and imaging data of both groups. Using multivariate logistic regression, we assessed risk factors of ABRS complications. Results: No socio-demographic characteristics were associated with ABRS complications (p ≥ 0.05). Factors associated with complications were delay in consultation (t = 5.282;p Conclusions: Intracranial and extracranial complications of ABRS in children have become rare in our setting. These complications can be serious and potentially fatal. Risk factors of these complications are delays in consultation, the presence of ophthalmological signs, and more than one affected sinus. Controlling modifiable factors would improve the treatment success of ABRS complications in children.展开更多
Introduction: Vitamin D plays a key role in phosphocalcic metabolism, in normal functioning of the immune system and in the prevention of certain forms of cancer. Systematic vitamin D supplementation has been implemen...Introduction: Vitamin D plays a key role in phosphocalcic metabolism, in normal functioning of the immune system and in the prevention of certain forms of cancer. Systematic vitamin D supplementation has been implemented in most Western countries, which has drastically reduced the prevalence of rickets. In Senegal, a country with enough sunshine, no large-scale data exists on vitamin D deficiency in children. In addition, there are no guidelines from the Ministry of Health and Social Action (MoHSA) on vitamin D supplementation. Our objective was to determine the prevalence of vitamin D deficiency in children aged 6 to 59 months and to analyze the factors associated with it at the Institute of Social Pediatrics in Pikine-Guédiawaye, a suburb of Dakar. Patients and Methods: This was a prospective, descriptive and analytical cross-sectional study over a 3-month period (from January to March 2024) at the Institute of Social Pediatric (IPS) of Pikine-Guédiawaye. The study population consisted of all children aged 6 to 59 months free from any acute or chronic pathology, whose parents had agreed to answer the questionnaires after having consented and signed the consent and children who had had a sample taken for vitamin D dosage. Results: We included 102 children, 35 of whom had vitamin D deficiency, i.e. a prevalence of 34.31% with a slight male predominance (sex ratio 1.05). Infants aged 13 - 24 months were more affected (41.67%), but the difference was not statistically significant (p-value = 0.385). Patients with acute malnutrition had a significantly higher prevalence of vitamin D deficiency (54.17% of cases versus 28.38%) in those without acute malnutrition (p = 0.02). On the other hand, chronic malnutrition, underweight and diversification foods were not significantly associated with vitamin D deficiency (p of 0.60, 0.42 and 0.09 respectively). Conclusion: Vitamin deficiency affects one-third of apparently healthy children under 5 and this deficiency has no significant relationship with diversification foods. This suggests that the observed vitamin D deficiencies are less related to diet than to lack of sun exposure.展开更多
Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 -...Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 - 15 years. Patients and Methods: This was a prospective cross-sectional study from April 1, 2021 to March 31, 2022 and affected all children aged 0 to 15 years old with a temperature of 39˚C or higher (≥), having less than five days and hospitalized in the pediatric department of the Gabriel Touré University Hospital. Results: During the study period, 150 children were included, the sex-ratio was 0.85. Children aged 0 - 5 years represented 71.4% of the sample. References represented more than half of the sample, or 58% of cases. Body temperature was above 40˚C in 18.7% of cases. Functional signs were dominated by respiratory signs in 28% and digestive signs in 18%. Clinical pallor was found in 55.3% of children associated with signs of respiratory struggle in 70% of cases and tachycardia in 40% of patients. Anemia was present in 65.3% of patients. Hyperleucocytosis and leukopenia were found in 45.3% and 43.3% of patients respectively. The C-reactive protein was positive in 44.7% of patients and Cytobacteriological Examination and Chemistry of Cerebrospinal Fluid was positive in 8.7% of cases. The thick drop was positive in 44.7% of patients and blood cultures grew in 6 patients. Etiology was dominated by severe malaria 54 cases (36%), pneumonia (19.3%), meningitis (12.6%), and in those under one month it was bacterial neonatal infection (8.6%). In our study, slightly more than one patient out of three died during hospitalization, 36% (54 cases/150) and among these 70% (38 cases/54) were under 5 years old. The most lethal pathologies were severe malaria (36%), bacterial pneumonia (19.3%), meningitis (12.6%), bacterial neonatal infections (8.6%) and measles complicated by pneumonia (5.3%). Mortality during hospitalization was 36% of deaths (54 out of 150 patients) and 70.3% (38/54) of the deceased patients were under 5 years old. Conclusion: This study shows that fever is a frequent symptom and a sign of serious and very lethal pathologies. The cause of fever can be a diagnostic challenge for health workers. However, early identification of children at risk for serious illness could allow for prompt and appropriate management in appropriate settings.展开更多
Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age w...Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age was 8 years with a sex ratio of 2.45. In 68.4% of cases, trauma occurred in road traffic accidents. Average consultation time was 2.4 hours. Trauma mainly affected the leg in 39.5% of cases, and the thigh in 34.2%. Soft tissue wounds occurred in 52.6% of cases, and open fractures in 47.4%. Average response time was one hour. Wound trimming and suturing were performed in 76.3% of cases and combined with bone nailing in 15.8%. The outcome was favorable in 92.1% of cases. Average hospital stay was 4.37 days. Conclusion: Open trauma to the lower limb is a frequent and occurs mainly in road traffic accidents. Management was early, with a favorable outcome for most patients and a short hospital stay.展开更多
BACKGROUND Although breast milk is ideal for newborns,in some cases,it is replaced with cow’s milk,which contains proteins that increase the risk of cow’s milk protein allergy(CMPA).AIM To evaluate CMPA prevalence i...BACKGROUND Although breast milk is ideal for newborns,in some cases,it is replaced with cow’s milk,which contains proteins that increase the risk of cow’s milk protein allergy(CMPA).AIM To evaluate CMPA prevalence in Bahrain and compare clinical characteristics of children with immunoglobulin E(IgE)-and non-IgE-mediated CMPA.METHODS This retrospective cohort study examined children with CMPA diagnosed at the pediatric gastroenterology outpatient clinic of the Salmaniya Medical Complex,Bahrain,between 2014 and 2022,and assessed CMPA prevalence.Clinical presentations,laboratory findings,dietary modifications,and outcomes were compared between children with IgE-mediated and non-IgE-mediated CMPA.Categorical variables were compared using Fisher’s exact test or Pearson’sχ2 test,whereas continuous variables were compared using Student’s t-test or the Mann-Whitney U test.RESULTS Of 8332 patients,6022(72.3%)adhered to their appointment.Of them,618(10.3%)were suggested of having CMPA and 595(96.3%)were included;CMPA prevalence was 2%.Most patients were Bahraini(93.8%)and males(55.3%).Non-IgE-mediated type accounted for 77.3%cases and IgE-mediated type,22.7%.IgE-mediated CMPA presented more in boys(P=0.030),and later in life(5.1 months±4.5 months vs 4.2 months±4.2 months,P=0.016,95%CI:0.08-1.73),had more associated diseases(P<0.001);and presented with more cutaneous(P=0.024)and respiratory(P=0.003)manifestations,severe symptoms[rash/dry skin(P=0.031),facial swelling/angioedema(P=0.003),failure to thrive(P=0.013),apparent life-threatening event(P<0.001)],and positive physical findings(P=0.002)than non-IgE-mediated CMPA.Most patients were exclusively fed cow milk formula(50.3%).The amino acid-based formula(AAF)was most prescribed(60.5%)with no difference between the two types(P=0.173).Although breastfeeding was recommended to 49.6%,only 8.2%were exclusively breastfed.IgE-mediated CMPA was associated with a longer follow-up duration than non-IgE-mediated CMPA(17.3 months±14.0 months vs 13.5 months±13.4 months,P=0.005,95%CI:1.1-6.3).CONCLUSION This study revealed a high CMPA prevalence with clinical differences between both types that can influence treatment.AAF was most prescribed,while breastfeeding with dietary modification is rarely applied.展开更多
Introduction: Reducing and maintaining viral load is crucial to reducing morbidity and mortality associated with HIV infection in children. The aim of this study was to determine the factors influencing the maintenanc...Introduction: Reducing and maintaining viral load is crucial to reducing morbidity and mortality associated with HIV infection in children. The aim of this study was to determine the factors influencing the maintenance of children and adolescents on antiretroviral therapy in the continuum of care. Methodology: This was a descriptive and analytical cross-sectional study conducted from August 1 to August 31, 2023. It included all children living with HIV, under 15 years of age, with at least two viral load results and whose parents consented to participate in the study. Participants were recruited during their child’s treatment renewal consultations. Results: The study included 143 children, mostly boys (55.2%), with a mean age of 11.54 years (±2.8). More than half (55.2) were unaware of their HIV-positive status, and most treatments were administered by parents (60.8%). Of the 99 children with an undetectable viral load at the first test, 23 (23.2%) showed a viral rebound at the last test, mainly due to poor treatment compliance (p Conclusion: Virological rebound after suppression in children is worrying. It is crucial that the national AIDS program improves Therapeutic Education, trains health workers to communicate results and encourages ongoing dialogue with young people to reinforce adherence and maintain viral suppression.展开更多
Introduction: Refractive errors in school children continue to receive less attention and priority in many developing countries. Refractive errors can be a source of poor vision and disinterest in school. The aim of t...Introduction: Refractive errors in school children continue to receive less attention and priority in many developing countries. Refractive errors can be a source of poor vision and disinterest in school. The aim of this study was to describe the epidemiological and clinical characteristics of ametropia in school children. Materials and Methods: This was a descriptive cross-sectional study carried out at the International Ophthalmology Center of Mali covering the period from January 1 to June 30, 2024, involving all school children. Results: A total of 207 children out of 702 school children received during the study period presented refractive errors. The most affected age group was 16 - 20 years old, with an average age of 16.95 years. The female sex was the majority, with 77.2% compared to 22.2% for the male sex. The main reasons for consultation were visual fatigue (36.2%) and tearing (20.2%). Hyperopia astigmatism was the most common refractive error, with a frequency of 62.3%. Low ametropia (Discussions: The management of refractive errors in school children is a major factor in their educational success. Conclusion: Early detection and management of refractive needs in school children can be key elements allowing them to be more efficient in daily activities.展开更多
文摘Objective: To study the effects of starting antiretroviral treatment (ART) prior the age of two years on the growth (height and weight) of HIV-infected children. Methodology: This was a retrospective cohort study. HIV-infected children on ART aged less than 15 years were divided into two groups Group 1 (G1) comprising children who started ART prior 2 years and Group (G2) those put on treatment thereafter. Main Measures: Percentage of children with growth retardation measured by Height for Age (H/A) and Weight for Age (W/A) Results: In total, we included 90 subjects. The median age was 10 years with a slight female predominance (51.2%). Most children were asymptomatic at the time of the study (96.6%), compliant with treatment (81%), 54.8% of children were on cotrimoxazole, 33% knew their status. At initiation, underweight was predominant in group 1 compared to group 2 (52% versus 29.5%;p = 0.015). Conversely, stunted growth predominated in G2 compared to G1 but without significant difference (38% versus 50%;p = 0.147). At the time of our study (median age of 10 years), catch-up height and weight predominated in G1 compared to G2;only a small proportion remained below −2SD (4% versus 18.2%;p = 0.015 and 9% versus 29.5%;p = 0.006 respectively for underweight and stunted growth). Conclusion and Global Health Implications: Growth retardation was common at ART initiation. Catch-up in height was more evident in the early treatment group. Initiation of ART before the age of 2 years rather influences children’s height than weight. The result of this study further emphasizes the need of early ART and closed clinical monitoring to better assess the impact of ART in areas with high rates of undernutrition.
文摘Introduction: Human immunodeficiency virus (HIV) is a major public health problem with high morbidity and mortality among children. The objective of this work was to audit the deaths of children and adolescents with HIV infection followed up in the pediatric department of the Regional Teaching Hospital of Borgou/Alibori (CHUDB/A) the from 2005 to 2020. Patients and Method: This was a retrospective and descriptive study conducted in the pediatric department of CHUD/B-A in Parakou. All children with HIV infection who died from January 1, 2005 to August 31, 2020 were included. Data collection was carried out in three stages: a phase of medical records processing, a phase of community survey and a phase of death audits. The variables studied were sociodemographic, clinical, biological, therapeutic and evolutionary. Results: Over the study period, the data of 464 infected children were recorded, including 92 deaths, representing a case fatality rate of 19.83%. Severe acute malnutrition (69.23%), gastro-intestinal tract infections (43.58%) and serious opportunistic pulmonary infections (24.36% pulmonary tuberculosis and 19.23% pneumocystis) were the main causes of death. The main dysfunctions found were: the delayed diagnosis of HIV infection (79.35%), the absence or delay in consultation when the child’s clinical condition deteriorates (32.61% and 47.83%), delayed initiation of antiretroviral treatment (42.39%) and non-adherence to treatment (38.04%). Non-adherence to treatment was predominant in adolescents (90.49%). Conclusion: Specific interventions for early detection, adequate nutritional care, psychosocial support for adolescents and mothers of children are necessary to reduce mortality due to HIV among children and adolescents.
基金supported by the Faculty of Medicine Siriraj Hospital,Mahidol University,Bangkok,Thailand,[Grant Number(IO)R015832028].Oxford Immunotec and Biomed diagnostics(Thailand)provided the T-SPOT.TB test kit
文摘Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in HIV-infected children and adolescents with immune reconstitution.Methods:A cross-sectional study was conducted in HIV-infected patients aged 5-18 years receiving antiretroviral treatment with CD4 T-lymphocytes>25%or>500 cells/mm3 for at least 6 months.QuantiF ERON-TB Gold,T-SPOT.TB,and tuberculin skin test were performed in each patient.Results:A total of 50 patients were enrolled with median age of 13.7 years,CD4 counts of 753(IQR:587-989)cells/mm3.Among 27 patients with tuberculosis(16)or tuberculosis exposure(11),8(29.6%)were positive to at least one test,2(7.4%)were positive QuantiFERON-TB Gold,3(11.1%)positive T-SPOT.TB,and 7(25.9%)had tuberculin skin test≥5 mm.Among 23 patients without history of tuberculosis or exposure,all had negative interferon gamma release assays,while 2(8.7%)had positive tuberculin skin test.Conclusions:All tests had low sensitivity despite immune reconstitution.
文摘Objectives: Antiretroviral therapy (ART) has been associated with lipodystrophy in children. We evaluated changes in various anthropometric measurements for the assessment of lipodystrophy and assessed whether there was an association with use of protease inhibitors (PI), non-PI containing ART and/or stavudine (d4T). Methods: Eighty-five HIV-infected children attending the HIV clinic at Great Ormond Street Hospital (GOSH) were included. The average follow-up was 8.4 months (range 3 - 12 months). Body fat redistribution was assessed by anthropometric measurements including skinfold thickness and circumferences of upper and lower limbs. Measurements were converted to age- and sex-adjusted z-scores through development stages including puberty. Results: Sixty children had taken ART;37 received PI-containing;38 received d4T;25 had never been treated. In the studied population, clinically important changes with decreases in biceps (BSF), subscapular skinfolds and total body fat (4SFT) over period of 12 months were observed. Some increase was noticed in triceps skinfolds (TSF). Limbs circumferences remained at the same level. Further we looked at 4 months basis changes in anthropometric measurements stratified by baseline ART. Generally z-scores of anthropometric measurements were lower in therapy naive children when compared to ART groups. PI-based ART regimens resulted in significant increases in BSF with a trend towards increases in TSF, suprailiac and 4SFT. Mid-arm and thigh circumferences were higher in PI compared to naive group. Similarly, significant changes in BSF z-scores were associated with d4T use. Increases were seen in TSF and mid-arm circumference and decreases were observed in subscapular skinfolds and calf circumference z-scores. Conclusions: Body fat redistribution in HIV-infected children with sub-clinical lipodystrophy could be detected by anthropometric measurements, particularly when PI or d4T is included in ART. Over time, changes with increase in arm and trunk fat, and no change or decrease in leg fat were more pronounced among ART-receiving children.
文摘Background: Streptococcus pneumoniae (pneumococcus) is one of the most frequent causes of bacterial infection in children and is a leading cause of otitis, sinusitis, pneumonia, and meningitis worldwide. Nasopharyngeal colonization is a risk factor for pneumococcal disease, a leading cause of complications and death in infants. HIV-infected persons are at high risk of invasive pneumococcal disease. Method: Nasopharyngeal swabs were collected from 296 HIV infected children below five years recruited from Gertrude’s Children hospital and Nazareth Hospital Nairobi, Kenya. The nasopharyngeal swabs were processed to isolate S. pneumoniae, which were serotyped and tested for drug susceptibility. Results: The carriage prevalence of S. pneumoniae in the study was 30.4% while the isolated serotypes were (in order of decreasing frequency): 35B, 19F, 3, 13, 15A, 11A, 16F, 7C and 23A. Most of the serotypes were resistant to the commonly used antibiotics but all were susceptible to vancomycin and chloramphenicol. Conclusion: Carriage prevalence of nasopharyngeal S. pneumonia in HIV infected children was lower than that of similar prevalence studies in children. Most of the S. pneumoniae isolates were however non pneumococcal vaccine isolates.
文摘Introduction: Multiple endocrine and metabolic abnormalities, particularly overweight and obesity, have emerged as significant global public health concerns. This paper examines the impact of these conditions on health outcomes and underscores the necessity for comprehensive strategies to address them. Background: Overweight and obesity have been observed in patients with human immunodeficiency virus (HIV) both before and after the initiation of antiretroviral therapy. This study investigates the risk factors associated with overweight and obesity in HIV-infected patients. Methods: A total of 492 HIV-infected patients, both treatment-naïve and those undergoing treatment, were recruited from Yaoundé Central Hospital in Cameroon. Demographic, anthropometric, and biochemical data were collected from each patient. Blood pressure and abdominal fat measurements were also taken. Metabolic syndrome was defined according to IDF criteria. Patients were categorized into two weight status groups: underweight/normal weight and overweight/obese. Results: The prevalence of overweight and obesity was found to be 27.5% and 8.5%, respectively, with only 6.1% of patients being underweight. Abdominal obesity, systolic/diastolic blood pressure, metabolic syndrome, and CD4 cell counts were associated with risk factors in overweight and obese patients. These parameters should be considered when investigating metabolic disorders in HIV-infected patients, as in the general population. Conclusion: Our study indicates a high risk of developing metabolic syndrome among overweight/obese individuals, who were 5.7 times more likely to have metabolic syndrome compared to those of normal weight/underweight. These findings support the hypothesis that overweight and obesity are also prevalent in HIV-infected patients and they are risk factors that have to be taken into consideration to better manage this issue. These results may provide essential information on the fact that being underweight is not the only issue to take into consideration in these patients but that overweight/obesity is now present. Prevention and management strategies should consider both aspects.
文摘Mycoplasma pneumoniae(M.pneumoniae)is a common pathogen that causes community-acquired pneumonia in children.The clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractory cases.Complications may occur,such as necrotizing pneumonia and respiratory failure.Extrapulmonary complications,including encephalitis,myocarditis,nephritis,hepatitis,or even multiple organ failure,can also arise.In this editorial,we dis-cuss the clinical implications of the significant findings from the article"Serum inflammatory markers in children with M.pneumoniae pneumonia and their predictive value for mycoplasma severity"published by Wang et al.They reported that measuring lactic dehydrogenase,interleukin-6 levels,and D-dimer effectively predicts refractory M.pneumoniae pneumonia cases.
文摘Objective: Studies available on cognitive function among school-aged HIV-infected African and in particular Nigerian children are few. The purpose of the study was to assess the neurocognitive function of a group of HIV-infected schoolaged (6 - 15 years) children using the Raven’s Standard Progressive Matrices (RPM). Method: Cognitive assessments of 69 HIV positive children and 69 age- and sex-matched apparently healthy HIV negative control children were performed using the Raven’s Standard Progressive Matrices (RPM). The children were subdivided (Piaget’s developmental staging) into two sub-groups: the concrete operation stage (6 - 11 years) and the formal operation stage (12 - 15 years) for analysis. Result: The mean RPM score for the HIV positive children was 18.2 (8.0 - 47.0, SD 9.8) which was significantly lower than the score of 27.2 (8.0 - 52.0, SD 13.8) for the HIV negative children (p < 0.001). On the RPM grading and using the HIV negative children as the standard, 56.5% of the HIV positive children had cognitive performance at below average to intellectually defective range. Conclusion: School-aged HIV positive children had significantly lower cognitive scores compared with age and gender-matched HIV negative children. Routine neuropsychological evaluation of all school-aged HIV-infected children is recommended. Early detection of cognitive impairment will help in planning appropriate interventions.
文摘Objective This study aimed to analyse the trend of the mental disorder spectrum in children and adolescents from 2014 to 2022 in one city in Central China and to provide actionable recommendations for the prevention and management of mental disorders.Methods In this hospital-based retrospective study,we utilized child and adolescent medical records data from the Wuhan Mental Health Center from January 2014 to December 2022 and examined the top 5 mental disorders(schizophrenia,depressive episode,bipolar disorder,pervasive developmental disorder,and unspecified mood disorder)that accounted for the overall proportion of patients admitted.The rank and proportion of these mental disorders,demographic characteristics and disease indicators were analysed.Results There was a significant upwards trend in the number of children and adolescents diagnosed with mental disorders over the past 9 years,with a sharp decline in 2020 due to the COVID-19 pandemic,followed by a rebound in 2021 and a sustained level above prepandemic figures by 2022.The average age of hospitalization decreased significantly from 20.7 to 16.2 years,with a marked increase in the 12-17-year-old age group.The proportion of female hospitalizations increased from 39.2%to 55.2%,with a corresponding decrease in male hospitalizations.There was a notable decrease in the proportion of schizophrenia cases and an ascent of depressive episode to the most prevalent position.Conclusion This study emphasizes the critical need for targeted interventions and resources for severe mental disorders in children and adolescents and the importance of early detection and management of mental disorders to mitigate long-term effects on well-being and development.
文摘·AIM:To identify various risk factors that may play a significant role in the development of congenital nasolacrimal duct obstruction(CNLDO).·METHODS:This observational case-control study included a case group of 122 children less than two years of age with CNLDO who underwent probing and irrigation treatment at the ophthalmology department of Imam Khomeini Hospital in Ahvaz,Iran,from June 2022 to June2024.A control group of 122 age-matched children without CNLDO was also included for comparison.Data was collected from the children's medical records.·RESULTS:The study found a significant correlation between the occurrence of CNLDO and several maternal factors,such as preeclampsia,the use of levothyroxine,hypothyroidism,having more than three pregnancies(gravidity>3),natural pregnancy,and gestational diabetes mellitus.Additionally,in children,factors,such as oxygen therapy,anemia,reflux,jaundice,and a family history of CNLDO in first-degree relatives were associated with CNLDO,and maternal preeclampsia and hypothyroidism were found to significantly increase the risk of developing CNLDO in children.·CONCLUSION:Given that CNLDO affects both premature and full-term children,the present findings may potentially facilitate the early identification of children and infants at risk of nasolacrimal duct obstruction,thereby preventing the onset of chronic dacryocystitis.
基金supported by the STI 2030-Major Projects,No. 2021ZD0200500 (to XS)。
文摘Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).
基金Supported by the Shijiazhuang Science and Technology Research and Development Program,No.221460383.
文摘BACKGROUND Emotional reactions,such as anxiety,irritability,and aggressive behavior,have attracted clinical attention as behavioral and emotional problems in preschool-age children.AIM To investigate the current status of family rearing,parental stress,and behavioral and emotional problems of preschool children and to analyze the mediating effect of the current status of family rearing on parental stress and behavioral/emo-tional problems.METHODS We use convenience sampling to select 258 preschool children in the physical examination center of our hospital from October 2021 to September 2023.The children and their parents were evaluated using a questionnaire survey.Pearson's correlation was used to analyze the correlation between child behavioral and emotional problems and parental stress and family rearing,and the structural equation model was constructed to test the mediating effect.RESULTS The score for behavioral/emotional problems of 258 preschool children was(27.54±3.63),the score for parental stress was(87.64±11.34),and the score for parental family rearing was(31.54±5.24).There was a positive correlation between the behavioral and emotional problems of the children and the“hostile/mandatory”parenting style;meanwhile,showed a negative correlation with the“support/participation”parenting style(all P<0.05).The intermediary effect value between the family upbringing of parents in parental stress and children's behavior problems was 29.89%.CONCLUSION Parental family upbringing has a mediating effect between parental stress and behavioral and emotional problems of children.Despite paying attention to the behavioral and emotional problems of preschool-age children,clinical medical staff should provide correct and reasonable parenting advice to their parents to promote the mental health of preschool-age children.
文摘Determining the predictors of screen media use will assist nurses and clinicians to identify the children that are in most need for intervention. There is limited literature regarding the predictors of screen media use among children. This study aimed to examine the association between selected predictors and screen media use among children aged 3 - 13. The findings of this study are based on 192 children aged 3 - 13 and their caregivers recruited from Facebook and WhatsApp groups. A descriptive cross-sectional design was employed. The participants filled a demographic questionnaire and the Problematic Media Use Measure Short Form to obtain data about parents’ and children characteristics, screen time and problematic use of media. The screen time for 83% of the children was more than two hours. Mobile ownership (beta (β) = 0.22) and conflict about mobile use (beta (β) = 0.16) have significantly predicted the child total screen time. Child age (beta (β) = 0.17) and conflict about mobile use (beta (β) = −0.33) have significantly predicted the problematic use of media. Most children in the current study exceeded the recommended screen time. There is an urgent need to implement interventions that mitigate children’s excessive use of media.
文摘Background: In children, acute bacterial rhinosinusitis (ABRS) is often complicated by ophthalmological and/or neurological involvement. These complications should be known and recognized, as they require urgent treatment with intravenous antibiotics and close in-hospital monitoring. In this study, we aimed to identify the main risk factors associated with the development of complications in children aged 2 - 17 years with ABRS. Methods: We conducted a retrospective cohort study of patients with ABRS complications in a primary hospital. Participants were divided into two groups: the control group comprising patients without complications (Group 1, n = 82) and the study group comprising patients with complications requiring hospitalization (Group 2, n = 41). We assessed the sociodemographic, clinical, and imaging data of both groups. Using multivariate logistic regression, we assessed risk factors of ABRS complications. Results: No socio-demographic characteristics were associated with ABRS complications (p ≥ 0.05). Factors associated with complications were delay in consultation (t = 5.282;p Conclusions: Intracranial and extracranial complications of ABRS in children have become rare in our setting. These complications can be serious and potentially fatal. Risk factors of these complications are delays in consultation, the presence of ophthalmological signs, and more than one affected sinus. Controlling modifiable factors would improve the treatment success of ABRS complications in children.
文摘Introduction: Vitamin D plays a key role in phosphocalcic metabolism, in normal functioning of the immune system and in the prevention of certain forms of cancer. Systematic vitamin D supplementation has been implemented in most Western countries, which has drastically reduced the prevalence of rickets. In Senegal, a country with enough sunshine, no large-scale data exists on vitamin D deficiency in children. In addition, there are no guidelines from the Ministry of Health and Social Action (MoHSA) on vitamin D supplementation. Our objective was to determine the prevalence of vitamin D deficiency in children aged 6 to 59 months and to analyze the factors associated with it at the Institute of Social Pediatrics in Pikine-Guédiawaye, a suburb of Dakar. Patients and Methods: This was a prospective, descriptive and analytical cross-sectional study over a 3-month period (from January to March 2024) at the Institute of Social Pediatric (IPS) of Pikine-Guédiawaye. The study population consisted of all children aged 6 to 59 months free from any acute or chronic pathology, whose parents had agreed to answer the questionnaires after having consented and signed the consent and children who had had a sample taken for vitamin D dosage. Results: We included 102 children, 35 of whom had vitamin D deficiency, i.e. a prevalence of 34.31% with a slight male predominance (sex ratio 1.05). Infants aged 13 - 24 months were more affected (41.67%), but the difference was not statistically significant (p-value = 0.385). Patients with acute malnutrition had a significantly higher prevalence of vitamin D deficiency (54.17% of cases versus 28.38%) in those without acute malnutrition (p = 0.02). On the other hand, chronic malnutrition, underweight and diversification foods were not significantly associated with vitamin D deficiency (p of 0.60, 0.42 and 0.09 respectively). Conclusion: Vitamin deficiency affects one-third of apparently healthy children under 5 and this deficiency has no significant relationship with diversification foods. This suggests that the observed vitamin D deficiencies are less related to diet than to lack of sun exposure.
文摘Fever is the primary reason for consultation and admission to pediatric emergency departments. The aim of this study was to describe the clinical, etiological and prognostic aspects of acute fever in children aged 0 - 15 years. Patients and Methods: This was a prospective cross-sectional study from April 1, 2021 to March 31, 2022 and affected all children aged 0 to 15 years old with a temperature of 39˚C or higher (≥), having less than five days and hospitalized in the pediatric department of the Gabriel Touré University Hospital. Results: During the study period, 150 children were included, the sex-ratio was 0.85. Children aged 0 - 5 years represented 71.4% of the sample. References represented more than half of the sample, or 58% of cases. Body temperature was above 40˚C in 18.7% of cases. Functional signs were dominated by respiratory signs in 28% and digestive signs in 18%. Clinical pallor was found in 55.3% of children associated with signs of respiratory struggle in 70% of cases and tachycardia in 40% of patients. Anemia was present in 65.3% of patients. Hyperleucocytosis and leukopenia were found in 45.3% and 43.3% of patients respectively. The C-reactive protein was positive in 44.7% of patients and Cytobacteriological Examination and Chemistry of Cerebrospinal Fluid was positive in 8.7% of cases. The thick drop was positive in 44.7% of patients and blood cultures grew in 6 patients. Etiology was dominated by severe malaria 54 cases (36%), pneumonia (19.3%), meningitis (12.6%), and in those under one month it was bacterial neonatal infection (8.6%). In our study, slightly more than one patient out of three died during hospitalization, 36% (54 cases/150) and among these 70% (38 cases/54) were under 5 years old. The most lethal pathologies were severe malaria (36%), bacterial pneumonia (19.3%), meningitis (12.6%), bacterial neonatal infections (8.6%) and measles complicated by pneumonia (5.3%). Mortality during hospitalization was 36% of deaths (54 out of 150 patients) and 70.3% (38/54) of the deceased patients were under 5 years old. Conclusion: This study shows that fever is a frequent symptom and a sign of serious and very lethal pathologies. The cause of fever can be a diagnostic challenge for health workers. However, early identification of children at risk for serious illness could allow for prompt and appropriate management in appropriate settings.
文摘Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age was 8 years with a sex ratio of 2.45. In 68.4% of cases, trauma occurred in road traffic accidents. Average consultation time was 2.4 hours. Trauma mainly affected the leg in 39.5% of cases, and the thigh in 34.2%. Soft tissue wounds occurred in 52.6% of cases, and open fractures in 47.4%. Average response time was one hour. Wound trimming and suturing were performed in 76.3% of cases and combined with bone nailing in 15.8%. The outcome was favorable in 92.1% of cases. Average hospital stay was 4.37 days. Conclusion: Open trauma to the lower limb is a frequent and occurs mainly in road traffic accidents. Management was early, with a favorable outcome for most patients and a short hospital stay.
文摘BACKGROUND Although breast milk is ideal for newborns,in some cases,it is replaced with cow’s milk,which contains proteins that increase the risk of cow’s milk protein allergy(CMPA).AIM To evaluate CMPA prevalence in Bahrain and compare clinical characteristics of children with immunoglobulin E(IgE)-and non-IgE-mediated CMPA.METHODS This retrospective cohort study examined children with CMPA diagnosed at the pediatric gastroenterology outpatient clinic of the Salmaniya Medical Complex,Bahrain,between 2014 and 2022,and assessed CMPA prevalence.Clinical presentations,laboratory findings,dietary modifications,and outcomes were compared between children with IgE-mediated and non-IgE-mediated CMPA.Categorical variables were compared using Fisher’s exact test or Pearson’sχ2 test,whereas continuous variables were compared using Student’s t-test or the Mann-Whitney U test.RESULTS Of 8332 patients,6022(72.3%)adhered to their appointment.Of them,618(10.3%)were suggested of having CMPA and 595(96.3%)were included;CMPA prevalence was 2%.Most patients were Bahraini(93.8%)and males(55.3%).Non-IgE-mediated type accounted for 77.3%cases and IgE-mediated type,22.7%.IgE-mediated CMPA presented more in boys(P=0.030),and later in life(5.1 months±4.5 months vs 4.2 months±4.2 months,P=0.016,95%CI:0.08-1.73),had more associated diseases(P<0.001);and presented with more cutaneous(P=0.024)and respiratory(P=0.003)manifestations,severe symptoms[rash/dry skin(P=0.031),facial swelling/angioedema(P=0.003),failure to thrive(P=0.013),apparent life-threatening event(P<0.001)],and positive physical findings(P=0.002)than non-IgE-mediated CMPA.Most patients were exclusively fed cow milk formula(50.3%).The amino acid-based formula(AAF)was most prescribed(60.5%)with no difference between the two types(P=0.173).Although breastfeeding was recommended to 49.6%,only 8.2%were exclusively breastfed.IgE-mediated CMPA was associated with a longer follow-up duration than non-IgE-mediated CMPA(17.3 months±14.0 months vs 13.5 months±13.4 months,P=0.005,95%CI:1.1-6.3).CONCLUSION This study revealed a high CMPA prevalence with clinical differences between both types that can influence treatment.AAF was most prescribed,while breastfeeding with dietary modification is rarely applied.
文摘Introduction: Reducing and maintaining viral load is crucial to reducing morbidity and mortality associated with HIV infection in children. The aim of this study was to determine the factors influencing the maintenance of children and adolescents on antiretroviral therapy in the continuum of care. Methodology: This was a descriptive and analytical cross-sectional study conducted from August 1 to August 31, 2023. It included all children living with HIV, under 15 years of age, with at least two viral load results and whose parents consented to participate in the study. Participants were recruited during their child’s treatment renewal consultations. Results: The study included 143 children, mostly boys (55.2%), with a mean age of 11.54 years (±2.8). More than half (55.2) were unaware of their HIV-positive status, and most treatments were administered by parents (60.8%). Of the 99 children with an undetectable viral load at the first test, 23 (23.2%) showed a viral rebound at the last test, mainly due to poor treatment compliance (p Conclusion: Virological rebound after suppression in children is worrying. It is crucial that the national AIDS program improves Therapeutic Education, trains health workers to communicate results and encourages ongoing dialogue with young people to reinforce adherence and maintain viral suppression.
文摘Introduction: Refractive errors in school children continue to receive less attention and priority in many developing countries. Refractive errors can be a source of poor vision and disinterest in school. The aim of this study was to describe the epidemiological and clinical characteristics of ametropia in school children. Materials and Methods: This was a descriptive cross-sectional study carried out at the International Ophthalmology Center of Mali covering the period from January 1 to June 30, 2024, involving all school children. Results: A total of 207 children out of 702 school children received during the study period presented refractive errors. The most affected age group was 16 - 20 years old, with an average age of 16.95 years. The female sex was the majority, with 77.2% compared to 22.2% for the male sex. The main reasons for consultation were visual fatigue (36.2%) and tearing (20.2%). Hyperopia astigmatism was the most common refractive error, with a frequency of 62.3%. Low ametropia (Discussions: The management of refractive errors in school children is a major factor in their educational success. Conclusion: Early detection and management of refractive needs in school children can be key elements allowing them to be more efficient in daily activities.
